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Shedding Light On Arizona’s Medigap Policies

In Arizona, medical beneficiaries who are in need of help for paying Medicare expenses must consider enrolling in a Medicare Supplement Plan known as Medigap Plan. It must be noted that Medigap plans are available through private insurance companies, not only in Arizona but in every state across U.S.

Medigap plans generally help with the expenses which are incurred under original Medicare plans which are Plan A and Plan B. Medigap plans are now almost same across all of the United States in terms of both policies and cost. For those of you who are not sure about the number of Medigap plans, just know that there are 10 standardized Medigap plans available in all of the states. The plans are labelled from A to N where Plan A and Plan B are the most basic plans which every state offers under the rule of federal administration.

If you are already enrolled original Medicare Plan A and B, then you are eligible to sign up for Medigap Plans. Not many people know but the best time to buy a Medicare Supplement plan is during the Medigap Open Enrollment Period. This period starts as soon as you reach the age of 65 and is also enrolled in Medicare Plan B. Individuals can sign up for any Medigap plans during this time according to the plans available in their state. The important thing to keep in mind is that there are no additional enrollment periods besides each of theirs Medigap Open Enrollment Period.

In Arizona and across all of the United States, Medigap plans doesn’t include prescription drug coverage, so you have to enroll in a Part D plan for prescription for separate Medicare to cover the cost of medicines or drugs. Prescription drug plans for Medicare Part D in Arizona are available through private insurance companies.
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It has been observed through the survey that Arizona is the most famous destination to retire. Surprisingly, above a million residents of Arizona are dependent on the Medicare for their main source of health insurance.While no revolutionary changes in Medicare supplement insurance is scheduled for 2016, there are some things to keep in mind which may affect the safety and availability of certain plans.

Here is the possible increase in premiums and Part B deductible. For example, Plan C, Plan F, and high deductible Plan F covers Part B deductible, so if the increased rates for these popular supplements may also increase. In Arizona, all the Medicare Supplement Plans must conform to the standards set by the Medicare Organization. Supplement standards include names from A to N. Each supplement offers basic benefits like coinsurance and blood donations. The only thing to remember is that every supplement is identical from one or another insurance company. In order to determine rates, you must compare different insurers providing Medigap plans however there should not be a big difference because of the Arizona Medigap Policy.  It is important that you familiarize yourself before  with the Medigap plan as well as each and every plan before you make any purchase. 

Supplement Plan F is the most comprehensive among the 10 other plans, covering almost 100 % of Medicare related costs. But even for Medicare Supplement Plan F recipients in Arizona can still incur some out – of -pocket expenses such as Medicare Part B premium.

As soon as you reach the age of 65, you need only a phone call to buy Medigap policy and get excellent coverage without question. And if you buy a policy in the first six months of enrolling in Medicare, you do not have to answer questions about your health. Do not worry if your doctors are not in the network, because you will be covered if you see any doctor who accepts Medicare.

Many people don’t realize the fact that how much they will be spending if they will be selecting the plan which covers the entire Medigap plans. There are total of 10 Medigap plans and each one has its own benefit. The four most comprehensive plans are C, D, F and G which account for more than 60% of all the Medigap sales according to Kaiser Family Foundation research. Plan F, the most expensive among all of them and covers every Medicare gap represents 40% of all policies sold. If your health is good than you must consider a plan which is not much comprehensive for e.g. Plan N and L are good choices because they will save you around $200 to $400 a year.

Medicare and Medigap benefits are identical in all 50 states, however policies and pricing rules may differ (Massachusetts, Minnesota and Wisconsin have their own standardized plans). If you know the rules in your state,  this may save you money.  You can choose when to upgrade an existing plan to switch to another insurer or drop your current Medicare plan during the annual open enrollment to change Medigap policies.

Most of the people become eligible for Medicare when they turn 65, although some beneficiaries can get Medicare even before if they have some kind of disability. You will automatically get Medicare as soon as you turn 65 if you are already receiving Social Security benefits. Otherwise, you will have to enroll in Medicare during the enrollment period.

There are also many private Medicare options available if you are a Medicare beneficiary in Arizona. Medicare coverage like drug prescription and supplemental coverage are only available through private insurance companies. Your private Medicare options will depend on where you live and the plans available in your area. We hope you found this article helpful as we shed light on Arizona’s Medigap policies. If you are an Arizona resident, feel free to contact www.azmedicare.info for further details. 

Arizona Medicare Advantage Plans

According to the latest statistics, a huge amount amount of retired people find Arizona the best place to live because of the warm climate and medical facilities. Millions of residents are depending upon the Medicare for health and life insurances. Since basic Medicare plan doesn’t cover everything, people may want Medigap or Medicare advantage plans.

Arizona is only state which has the most amount of Medicare recipients. Phoenix, Tucson and Mesa are the largest cities of Arizona and there are about 15% Arizonians who are 65 years and up receiving Medicare and about 14% Arizonians receiving Medicare. Almost all seniors are dependent on Medicare benefits for health insurance. Among all the senior citizens, approximately 30% will choose the Arizona Medicare Advantage plans. The other 25% will choose Medigap plan instead. The remainder may have a different public or private coverage, but most do not just rely on Part A and Part B Medicare, because they want to ensure that health care costs remain affordable.

Anyone choosing Medicare insurance or any other type of health insurance needs to strike a balance between premiums and benefits. Medicare Advantage plans for Arizona are attractive because many still have a very low or even $ 0 premium surcharge. Medicare Advantage plans also include Part D drug coverage at no additional cost.

On the other hand, these cheaper plans have many co-pays and deductibles. Also many recipients operate on a tight budget during retirement. Everyone has their own plans for retirement, for some people it makes more sense to pay a hefty amount for the Medigap insurances that covers all the health expenses that are not originally covered in Medicare.

Interestingly, Medicare supplement insurance plans C and F are usually the most expensive but they are also the most popular among the people who purchase supplements.

As a beneficiary, you are free to enroll in any Medicare Advantage plans you like. All the plans offer health benefits under Part A and Part B both. Many Medicare Advantage plans also cover prescription drug coverage (Part D). Additional benefits can also be utilized by paying an extra cost on your Medicare advantage plan. You may qualify for these plans if you are entitled to Medicare Part A and enrolled in Medicare Part B.
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There are many private companies who offer Medigap plans for senior citizens. People can easily sign up for one of several Medicare advantage plans if they want to receive the most of their medical insurance coverage company. Keep in mind that if you are going for Medicare advantage plan, you must be enrolled in Medicare Part A and B.

Secondly, you must be living in the area where they have Medicare network providing advantage plans. Most Medicare Advantage plans have prescription drug coverage built into the plan. This is not always the case, because it may be what is called stand-alone Part D plan.

Many people join the Medicare advantage plan as soon they turn 65. This process is called open enrollment period when you have only six months to enroll in the plan. After registration, if you want to change your plan, you’ll have to wait until the annual election period, which occurs every year from October 15 to December 7th. During this time, you can switch plans or return to original Medicare options, for this year you will not be able to move out of your plan, or join a new Medicare Advantage plans for 2016 outside of that enrollment period.

Type of Medicare Advantage Plans:

Below listed are some of the main advantage plans available across the United States:

Health Maintenance Organization (HMO):
Health Maintenance Organization plan only allows  you to select certain doctors and hospitals within the network. Unless it’s an emergency, only then can you go to those approved locations. If you plan to visit someone outside your network, it will not be covered under your plan and it will be charged separately.

Preferred Provider Organization (PPO):
Preferred Provider Organization plan allows you to save your money by selecting the specified doctor and healthcare provider or hospital. You will be required to pay a bit more if you wish to go to those that are not on the list of approved providers.

 Private Fee for Service (PPFS):
Private Fee for Service a plan which does not require you to go to an approved list of providers. Instead, you will have the choice to select any provider you want. The only drawback is that there are very few people who accepts the PPFS plan.

Special Needs Plans (SNPs):
Special Needs Plans are basically designed for the people who have some specific and severe disabilities and diseases. The list of accepted providers is made on the needs of the subscriber and who will be able to fulfill their needs.

Every Medicare advantage plan is created to operate on a network. It means that all health care providers will be located within a specific area. You are required to live in the local area if you want to get covered by a certain plan. If you move to a new area, you may change your provider or insurance plan, depending on where you moved and what type of network is used.

3.75M Medicare Recipients Will Get Donut Hole Check In 2010

According to figures released by the administration, more than 750,000 checks for $250 have already been mailed this summer to Medicare recipients who have exceeded their basic Medicare Part D benefits. The so-called “donut hole” is a gap in prescription drug coverage that will cause beneficiaries to pay the entire cost of their prescription drugs once their basic benefits are exhausted but before catastrophic drug coverage kicks in. Basic Medicare Part D coverage is exhausted when the beneficiary and his or her insurance company have spent a combined total of $2,830 on prescription medications in a single coverage year.

The problematic coverage lapse isn’t a minor issue. An estimated 3 million more checks will be mailed out before the end of the year, as more seniors qualify for the one-time rebate. The $250 check is the administration’s first step toward closing the donut hole altogether, a process that’s expected to take nearly ten years. Beginning next year, the cost of most prescription drugs will be halved for beneficiaries whose basic coverage runs out. Eventually, the gap will be eliminated entirely, and beneficiaries will maintain annual prescription drug benefits with no gaps in the coverage.

As part of the “gap reduction” plan in 2011, Medicare will “streamline” its Part D plans, which may mean fewer Part D plans to choose from. One of the new Part D rules for 2011 limits carriers from offering more than one Part D plan in a single coverage area. Medicare’s goal with the new rules is to reduce the number of confusing choices that confront beneficiaries during the annual enrollment period, but this may force nearly three million seniors enrolled in popular drug plans, such as the multiple Part D options offered by AARP and CVS-Caremark, to switch plans.

The AARP released a study last month that contradicted the Medicare administration claims that reforms will lower the cost of prescription drugs. In the AARP’s study of brand name drug costs, the organization said that in the last five years, the cost of the most popular prescription medications rose by 41.5%, more than tripling the 13.3% rise in the consumer price index for the same time period. Drug makers say that the AARP is being alarmist regarding the price of brand name drugs because about three-fourths of consumers in the US use lower-cost generic drug formulations.

2011 Medicare Part D Choices Require Research Says Firm

Avalere Health, a healthcare policy research firm, says that Medicare beneficiaries must do some research before making their Medicare Part D plan election for 2011.  The company says that significant changes await some enrollees, even if they elect the same Part D provider they had in 2010.  According to the company, many Medicare Part D providers have changed their formularies and co-pay costs, meaning that some drugs that were covered in 2010 may not be covered in 2011.

One of the more noticeable changes may be in the way providers structure co-pays.  According to Avalere Health, more providers are structuring their Part D plans with five or more tiers, which will allow providers to charge different co-pays for drugs in different plan tiers.  The number of tiered plans has risen from 27% in 2009 to more than 40% in 2011.  Some plans that already use tiered payment structures have two different tiers for generic drugs.

Another major change for consumers will be in their choice of pharmacy.  Some Part D plans will use preferred pharmacies and will base consumer out-of-pocket costs not only on the prescribed drugs, but also on whether or not prescriptions are filled at a participating pharmacy.  Consumers who use non-plan pharmacies may find themselves paying up to 50% more in out-of-pocket costs for prescription drugs.

More Part D plans are also using pre-authorization and limiting the quantity of medications that can be dispensed at one time, creating an overall higher cost to the consumer for pharmaceuticals in the form of additional co-pays.  The end result of these changes is a net decrease in the number of drugs covered by the top ten prescription drug plans (PDP) for 2011.

Among the top ten plans, the 2011 formularies cover between 50% and 87% of prescription drugs.  To illustrate the potential impact of changes among drug plans, Avalere’s analysis shows that while the AARP’s 2011 formulary covers four popular rheumatoid arthritis drugs with a 33% cost-share, Humana-WalMart’s 2011 formulary covers only two of the four drugs and has a 35% cost-share on the covered formulations. In addition, the cost-share at non-preferred pharmacies is significantly higher.  Enrollees must pay out-of-pocket for drugs not covered by their provider’s formulary. More information about the Avalere Health study can be found at AvalereHealth.net.

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